Rep. Jackie Haas

Filed: 3/1/2022

 

 


 

 


 
10200HB4545ham001LRB102 22906 KTG 37153 a

1
AMENDMENT TO HOUSE BILL 4545

2    AMENDMENT NO. ______. Amend House Bill 4545 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5adding Sections 5-30.12a and 5-45 as follows:
 
6    (305 ILCS 5/5-30.12a new)
7    Sec. 5-30.12a. Illinois Medicaid Program Advanced Cloud
8Technology. By October 1, 2023, the Department shall ensure
9that the Illinois Medicaid Program Advanced Cloud Technology
10system is updated daily with eligibility coverage information
11from the integrated eligibility system.
 
12    (305 ILCS 5/5-45 new)
13    Sec. 5-45. MCO post-payment audit; time period limitation.
14Notwithstanding any other provision of this Code, in order to
15recover an overpayment by recoupment or offset of future

 

 

10200HB4545ham001- 2 -LRB102 22906 KTG 37153 a

1payments, a managed care organization's post-payment audit of
2any claim submitted by a provider must be completed no later
3than one year after the claim's payment date. The one-year
4time limit does not apply to claims that are (i) submitted
5fraudulently, (ii) known, or should have been known, by the
6provider to be a pattern of inappropriate billing according to
7standard provider billing practices, or (iii) subject to any
8federal law or regulation that permits post-payment audits
9beyond one year.
 
10    Section 99. Effective date. This Act takes effect upon
11becoming law.".